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Updated gentamicin guidelines for adult and paediatric settings now available

Ensuring the safety and efficacy of Gentamicin, a powerful but potentially toxic antibiotic

Updated Gentamicin guidelines for once daily usage in adult and paediatric settings were launched in RCPI on Tuesday 29 November 2016.

The guidelines were developed by the Gentamicin Project Improvement Group, which is a collaboration of a number of sites across the Health Service Executive and the Royal College of Physicians of Ireland.

The guidelines are supported by

  • The National Hospital Antimicrobial Stewardship Committee
  • HSE/RCPI National Clinical Programme for the Prevention of Healthcare Associated Infection and Antimicrobial Resistance
  • The Irish Nephrology Society
  • The Irish Antimicrobial Pharmacists Group

The guidelines include recommended initial dosing regimen and recommended strategies for subsequent doses and therapeutic drug monitoring.

The launch in No.6 Kildare Street featured a keynote presentation from Dr Andrew Seaton, a Consultant in Infectious Diseases and General Medicine and Antimicrobial Management Team Lead for the NHS Greater Glasgow and Clyde Health Board. Dr Seaton presented on Antimicrobial Stewardship in Scotland, the highs, lows and lessons learned.

Small Difference between Optimal and Toxic Dosing

Gentamicin is the seventh most commonly used antibiotic in Irish hospitals, given to approximately 15,000 patients per annum.

It is a potentially life-saving drug, used to treat Gram-negative infections in some of the sickest patients in our hospitals.

However Gentamicin has a narrow therapeutic index. This means that there is only a small difference between optimal and toxic dosing.

Failure to achieve optimal dosing can lead to increased patient morbidity and mortality, and increased resistance. Overdosage can cause temporary or permanent kidney damage, loss of hearing or balance disturbance.

Optimal gentamicin usage is a regular focus for improvement, and there have been a number of examples of such improvement to date across the Irish healthcare service.

Dr Philip Crowley, National Director, Quality Improvement Division, HSE, Dr Andrew Seaton, Antimicrobial Management Team Lead NHS Greater Glasgow, Dr Rob Cunney, Clinical Lead HSE HCAI/AMR Clinical Programme

Start using the new gentamicin guidelines today

These guidelines can be used in cases where patients are receiving once daily gentamicin therapy (adult or paediatric), with the exception of patients receiving renal replacement therapy, pregnant patients or those with burns. It should be noted that this guideline document relies upon appropriate patient selection in choosing to use this drug. Careful consideration of the potential risks and benefits of usage of the drug should occur for every patient.

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